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ARTICLE |
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Year : 2015 | Volume
: 16
| Issue : 2 | Page : 76-80 |
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Effectiveness of subliminal music therapy on improvement of mental wellbeing among PLWHIV
SM Jahir Hussain1, Rogina J. S. Savarimuthu2
1 Nursing Tutor, College of Nursing, AIIMS, Uttarakhand, India 2 Associate Professor (Former), Christian College of Nursing, Ambilikkai, India
Date of Web Publication | 23-May-2020 |
Correspondence Address:
 Source of Support: None, Conflict of Interest: None

People living with HIV (PLWHIV) experience severe psychosocial problems. PLWHIV experience depression, bipolar disorder, post traumatic stress disorder, anxiety and substance abuse. These mental health issues contribute to poor mental wellbeing. The study was conducted at the Community Care Center, Family Planning Association of India (FPAI), Hospital, Madurai. Quantitative pre-experimental research design and purposive sampling technique was utilized in the study. Sixty PLWHIV were included in the study. Instruments consist of demographic variables and the Warwick-Edinburgh Mental Well-Being Scale. Half (50%) of the study subjects reported below average mental wellbeing in the pre-test which decreased to 33.3% in the post-test. Average and good levels of mental wellbeing in post-test significantly improved following the subliminal music therapy. This reveals that subliminal music therapy can contribute to improved mental wellbeing among PLWHIV. Nurses can administer the subliminal music therapy for PLWHIV to improve their mental wellbeing.
Keywords: music therapy, subliminal music therapy, mental wellbeing, PLWHIV
How to cite this article: Jahir Hussain S M, Savarimuthu RJ. Effectiveness of subliminal music therapy on improvement of mental wellbeing among PLWHIV. Indian J Cont Nsg Edn 2015;16:76-80 |
How to cite this URL: Jahir Hussain S M, Savarimuthu RJ. Effectiveness of subliminal music therapy on improvement of mental wellbeing among PLWHIV. Indian J Cont Nsg Edn [serial online] 2015 [cited 2022 Aug 16];16:76-80. Available from: https://www.ijcne.org/text.asp?2015/16/2/76/284865 |

Introduction | |  |
People living with HIV (PLWHIV) experience severe psychosocial problems (Choi, 2013). Researchers have reported PLWHIV experience depression, bipolar disorder, post traumatic stress disorder, anxiety, and substance abuse (Choi, 2013). These mental health issues contribute to poor mental wellbeing (Positive Nation, 2013). Psychosocial problems lead to poor adherence, treatment failure, and resistance (Choi, 2013). Music therapy has been reported to have positive effects on individuals experiencing various mental health problems (McDermott, Crellin, Ridder, & Orrell, 2013). Music therapy enables the client to experience music therapeutically within the client-therapist relationship. The subliminal music therapy offers positive suggestions and affirmations messages encoded within the music. The conscious mind hears only the music, whereas the subconscious mind hears the positive suggestions influencing the desired therapeutic effect (Brooks et al.,2012)
Psychologists believe that behavior and personality derives from the constant and unique interaction of conflicting psychological forces that operate on three different levels of awareness of the mind: the preconscious, the conscious, and the unconscious. Subliminal therapy is a psychological process in which the logic thinking functions of the conscious mind are circumvented and subtlety altered to form a new intended mindset in the client. Subliminal stimulation can be visual or auditory. Subliminal message can be signal or message designed to pass below the normal threshold of perception. The stimulus is inaudible to the conscious mind yet audible to the unconscious mind. Subliminal perceptions influence thoughts, feelings and actions of the perceiver (Giorgio, 2014). The subliminal music therapy utilizes music to offer auditory stimuli below an individual’s conscious perception threshold. The subliminal music therapy offers positive suggestions and affirmations messages encoded within the music. The intended message is masked within the music such that the conscious mind hears only the music, whereas the subconscious mind hears the positive suggestions influencing the desired therapeutic effect. The subliminal messages alter the negative thoughts supplementing with healthier and positive thoughts. Changes in the subconscious mind aid in changes in the conscious mind (Brooks et al., 2012; Lawrence, 2014).
Music therapy has been reported to be effective in the treatment of behavioral and psychiatric symptoms among clients with moderate to severe dementia, anxiety, pain, mood, and quality of life among clients with cancer, preoperative anxiety, postpartum pain and anxiety, clients with schizophrenia to improve their global state, mental state (including negative symptoms) and social functioning, pain and anxiety in palliative care, depression and to improve sleep and mental wellbeing (Guetin et al., 2013; Simavli et al., 2014). The researchers could not find any review of literature on the effectiveness of subliminal music therapy on the mental wellbeing of PLWHIV. Textbook on subliminal music therapy is dearth.
Subliminal stimulation has been reported to be effective. Subliminal psychodynamic activation is reported to have stronger effects than superluminal stimuli. Subliminal stimuli can produce temporarily stable changes in attitudes and behavior, contribute to weight loss, reduce shop lifting, improve academic performance, contribute to positive emotional concepts of conceptualizations, intentions and responses, influence decision making and mental health, illness, and its outcome. Research studies have reported nonspecific placebo effects of subliminal messages (Giorgio, 2014). Egermann, Kopiez, and Reuter (2006), research findings for effectiveness of subliminal messages in music on choice behavior supported null hypothesis. The researchers could not find any review of literature on the effectiveness of subliminal music therapy on the mental wellbeing of PLWHIV.
Objective
To assess the effectiveness of subliminal music in improving the mental wellbeing among PLWHIV.
Methods | |  |
A quantitative study using pre-experimental research design with one group pre-test post-test design was conducted at the Community Care Center, Family Planning Association of India (FPAI), hospital, Madurai to assess the effectiveness of subliminal music therapy in improving the mental wellbeing among PLWHIV. The FPAI hospital is the Madurai branch of the Family Welfare Society of India. The health care services provided by the hospital are antenatal, postnatal and intranatal care, temporary and permanent family planning methods, medical termination of pregnancy, infertility treatment, HIV testing and treatment, counseling, and follow-up care. The PLWHIV in-patients unit is a 23 bedded unit within the Community Care Center, FPAI hospital rendering medical care. More than 50 out-patients utilize the OPD everyday under the Rajaji Government Hospital, Madurai.
The population was PLWHIV admitted at the Community Care Center, Family Planning Association of India (FPAI), Madurai. Purposive sampling technique was used and the subjects were selected on the basis of their willingness to participate, being an in-patient with hospital stay for at least a week according to experts’ guidance. Each patient had a minimum hospital stay of1 week and maximum over weeks depending on their health condition. The patient turn-over was low. Hence the subject size was decided 60 with expert’s opinion as the subject size had to be represented in advance while requesting permission from the district collector and the director of FPAI. Subjects newly admitted were included in the study. Sixty PLWHIV were included in the study.
Data collection instruments
Instruments consisted of demographic variables and the Warwick-Edinburgh Mental Well-Being Scale. Demographic variables consist of age, gender, marital status, occupational status, duration of illness, family history of HIV infection, and mode of transmission.
The Warwick-Edinburgh Mental Well-Being Scale (NHS Health Scotland, 2012), is a standard scale developed by Warwick and Edinburgh. It consists of14 questions. Score ranges between 1 and 5. Score 1, 2, 3, 4 and 5 is assigned for responses none of the time, rarely, some of the time, often and all of the time respectively. The total score ranges between 14 and 70.
Validity and reliability
Demographic profile questionnaire was checked for validity by five experts. The Mental Wellbeing Scale is a standardized scale with validity .95 and reliability .83 (NHS Health Scotland, 2012).
The subliminal music was commercially obtained from the ANUGRAHA, Capuchin Institute for Counseling, Psychotherapy and Research, Dindigul, Tamilnadu which is recognized by the Canadian Association for Spiritual Care. The subliminal music is being utilized by ANUGRAHA in rendering mental health and spiritual services.
Data collection procedure
The primary investigator is a certified music therapist. He is certified in basic music therapy skills from The Valliammal Institution, Madurai.
Formal permission was obtained from the district collector and the director of FPAI. Oral consent was obtained from the study subjects after explaining the purpose of the study and were also assured about the maintenance of confidentiality. Using purposive sampling technique the subjects were selected. Individual client interviews were conducted to evaluate the pre-test assessment of mental wellbeing which was followed by detailed explanation with regard to the procedure, the music was played after which the oral consent was obtained from the subjects. The music therapy was commercially obtained from the ANUGRAHA, Capuchin Institute for Counseling, Psychotherapy and Research, Dindigul, Tamilnadu which is recognized by the Canadian Association for Spiritual Care, wherein the experts utilize it in rendering music therapy as a part of psychotherapy.
Ten subjects per week who fulfilled the inclusion criteria were included for the study for a period of six weeks. On the first day pre-test was conducted. Intervention was administered for four days. Post-test was conducted on the sixth day.
Intervention
From the second day till the fifth day, the subjects were made to assume a comfortable position and the subliminal music was administered through ear phones. From the second day to fifth day subliminal music which had the embedded subliminal messages on positive thinking, sound healing, sound sleep and total relaxation was administered each day. The subliminal music was administered three times per day (10am, 2pm, and 6pm) with the duration ranging from 25 to 40 minutes. Subliminal music on positive thinking and sound healing was administered at 10am, sound sleep at 2 pm and total relaxation at 6pm.
Results | |  |
Most of the subjects were between 41-50 years (48.33%), males (71.67%), married (51.67%), employed as coolies (76.67%), ill for 1-3 years (48.33%), had no family history of HIV infection (96.67%) and the use of contaminated injection was the mode of transmission (83.33%).
Half (50%) of the subjects reported below average mental wellbeing in the pre-test which decreased to 33.3% in the post-test. Average mental wellbeing was reported by 45% during the pre-test which rose to 58.3% in the post-test. Good mental wellbeing reported by 5% of the subjects during the pre-test which increased to 8.3% the post-test.
Subliminal music therapy was effective in improving mental wellbeing of the subjects (p value = .005) (see [Table 2]).
Discussion | |  |
Half (50%) of the subjects reported below average, 45% average and 5% good mental wellbeing in the pre-test which is supported by earlier study report that the PLWHIV experience various mental health issues contributing to poor mental wellbeing (Choi, 2013; Positive Nation, 2013). Mental wellbeing significantly improved among the subjects following the subliminal music therapy which is similar to former findings reported by Giorgio (2014) that subliminal stimulation is effective in the treatment of behavioral and psychiatric symptoms.
Limitations
The current study was limited in subject size, duration, and to one group pre-test post-test design. The effectiveness of subliminal music therapy on improvement of mental wellbeing among PLWHIV should be investigated in the future using a wider subject size and an experimental research design.[10]
Conclusion | |  |
Subliminal music therapy contributes to improved mental wellbeing among PLWHIV in combination of standard care. Nurses can administer the subliminal music therapy for PLWHIV to improve their mental wellbeing. Nurses should be empowered to identify poor mental wellbeing among PLWHIV clients. Subliminal music therapy is one of the non-pharmacological interventions aimed at working in the unconscious mind to bring about a desired effect. Every nurse should be trained and encouraged in the utilization of subliminal music therapy as a complementary approach along with the standard care.
Conflicts of Interest: The authors have declared no conflicts of interest.

References | |  |
1. | Brooks, J. S., Savoa, V., Allzen, E., Benedict, C., Fredriksson, R., & Schioth, B. H. (2012). Exposure to subliminal arousing stimuli induces robust activation in the amygdala, hippocampus, anterior cingulate, insular cortex and primary visual cortex: A systematic meta- analysis of MRI studies. NeuroImage, 59(3), 2962-2973. Retrieved from http://www.sciencedirect.com/science /article/pii/S 105381191101152. |
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3. | Egermann, H., Kopiez, R., & Reuter, C. (2006). Is there an effect of subliminal messages in music on choice behavior? Journal of Articles in Support of the Null Hypothesis, 4(2), 1539- 8714. Retrieved from http:// www.jasnh.co. |
4. | Giorgio, L. (2014). Subliminal message research-unleash limitless power. Retrieved from www.deeptrancenow .com/subliminal_messages.htm |
5. | Guetin, S., Charras, K., Berard, A., Arbus, C., Berthelon, P., Blanc, F., … Leger, J. M. (2013). An overview of the use of music therapy in the context of Alzheimer’s disease: A report of a French expert group. Dementia, 12(5), 619634. Retrieved from http://www.ncbi.nlm.nih.gov /pubmed/ 2433733. |
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7. | McDermott, O., Crellin, N., Ridder, H. M., & Orrell, M. (2013). Music therapy in dementia: a narrative synthesis systematic review. International Journal of Geriatric Psychiatry, 28(8), 781-794. Retrieved from http://www. ncbi.nlm.nih.gov/pubmed/ 2308021. |
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10. | Simavli, S., Kaygusuz, I., Gumus, I., Usluogullarý, B., Yildirim, M., & Kafali, H. (2014). Effect of music therapy during vaginal delivery on postpartum pain relief and mental health. Journal of Affective Disorders, 156, 194-199. Retrieved from http://www.ncbi.nlm.nih.gov /pubmed/ 2441168. |
[Table 1], [Table 2]
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